Quality Improvement Management Manager. The Contractor shall employ a Quality Improvement Management Manager who is dedicated full-time to the Contractor’s Indiana Medicaid product lines. The Quality Improvement Management Manager shall, at a minimum, be responsible for directing the activities of the Contractor’s quality management staff in monitoring and auditing the Contractor’s health care delivery system, including, but not limited to, internal processes and procedures, provider network(s), service quality and clinical quality. The Quality Improvement Management Manager shall assist the Contractor’s Compliance Officer in overseeing the activities of the Contractor’s operations to meet the State’s goal of providing health care services that improve the health status and health outcomes of Hoosier Healthwise members. For more information regarding the quality management requirements, see Section 6.
Quality Improvement Management Manager. The Contractor shall employ a Quality Management Manager who is dedicated full-time to the Contractor’s Indiana Medicaid product lines. The Quality Improvement Management Manager shall, at a minimum, be responsible for directing the activities of the Contractor’s quality management staff in monitoring and auditing the Contractor’s health care delivery system, including, but not limited to, internal processes and procedures, provider network(s), service quality and clinical quality. The Quality Improvement Management Manager shall assist the Contractor’s Compliance Officer in overseeing the activities of the Contractor’s operations to meet the State’s goal of providing health care services that improve the health status and health outcomes of HIP members. For more information regarding the quality management requirements, see Section 9.
